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Source * http://e-democracy.org/edebatemn06/?cat=12 E-Debate MN06 - Minnesota Gubernatorial E-Debate Topic 1 = Health Care Theme 1 - Health Care - Your Vision and Goals :Please detail what initiatives you will undertake to make quality health care more accessible and affordable for all Minnesotans. Share your vision and detail at least three goals with specific targets your Administration will seek to meet within the next four years. In your rebuttal, you are encouraged to contrast your approaches with the proposals of other candidates. What makes your plan better? Response from Mike Hatch - D We must stem the meteoric rise of health care costs and improve accessibility for all Minnesotans. Health premiums and out of pocket expenses have soared, with the rate increases slowing only because the insured pay higher co-payments and deductibles. As a result, fewer employers offer health insurance and 77,000 more Minnesotans are uninsured. The cost of health care is the largest tax on business and the most common cause of family bankruptcy. This is unconscionable. Here’s what we can do: • The State should negotiate lower prices for prescription drug medication on behalf of all Minnesota consumers. Prescription drugs compose 20 percent of the health dollar and is the fastest growing sector in health care. • Reduce the size of our uninsured population. The larger the uninsured population, the higher the premium increases on people who are insured. This effect is due to cost shifting. There are three groups who represent the uninsured and underinsured population in Minnesota: + Working Poor - currently, there is a $100 million surplus in the Health Care Access Fund. This surplus should be applied to the MinnesotaCare program to cover more of our “working poor”. + Young Adults - Minnesota law mandates that students between the ages of 18 and 25 be covered under their parent’s policy. Many states have removed the education requirement and Minnesota should do this as well. + Small Employers -should be able to stabilize their premiums by being able to purchase coverage for high-risk employees from the Minnesota Comprehensive Health Association (MCHA). • Our Attorney General (AG) audits of the three largest HMOs and two largest hospital systems revealed that up to 40 percent of the health dollar is spent on administration costs. By changing the governance of these institutions, we hopefully can dramatically reduce administrative costs. Some states now appoint members of such institutions in order to make them more accountable. We should consider this option. • Adopt the 75 recommendations from our AG audit report to the Pawlenty Administration. These recommendations range from pension rules to better financial accounting to placing caps on net worth (our HMOs and BCBSM have the highest net worth to premium ratio in the country). • Adopt a false claims act and whistleblower law. • Review the concept of Centers of Excellence as it relates to diagnostic centers and health provider clinics. Containing health care costs will help preserve and build a middle class in Minnesota—under a Hatch Administration we will get results. Response from Peter Hutchinson Can you imagine: * WORLD CLASS HEALTH for Minnesotans at a world competitive cost per person – a system that delivers best health and best care -at the best price- for every Minnesotan? * STAYING IN YOUR JOB because it matches your talents and lifestyle and not just because it offers health care insurance? * TAKING CARE OF A HEALTH CONDITION when it’s a small problem – before it becomes a really big and really expensive problem? Solving the health care crisis is not only critical for the state budget, but also for every business and family in Minnesota. Health care inflation is literally drowning our state and local governments. The flood of spiraling health care costs now soaks up all new revenue– all of it, and then some. Unless your governor does something about this, we can’t make key investments in any other important areas… transportation, education, environment. We just won’t have the money. Will this be easy? Absolutely not. But, ignoring this crisis is not an alternative. The only comprehensive plan for health care reform you can find this year is at www.TeamMN.com. I encourage you to read the full report; we project that it can save Minnesota governments about $1.7 billion with which we can improve education, assure health insurance for all, get transportation systems moving and clean up our waters and habitat. You’ll hear from Tim Pawlenty that our revenues are growing at a nice clip. What he doesn’t tell you is that health care costs are growing at an even greater clip. You need to ask him, “How can you call your budget responsible if you don’t effectively deal with the key cost factor?” Health care reform must not be optional. I think Minnesotans know this. The methods may be negotiable, but the ends are not. Here’s how we’ll save Minnesota governments $1.7 billion per year and improve the quality of health outcomes: * Improve quality of care (quality costs less) * Pay for prevention (costs less than treatment) * Cut the cost of bureaucracy/overhead by half * Mandate Minnesotans have basic health and long-term care insurance/provide help to those who can’t afford insurance * Put Minnesotans in charge of cost and quality choices (and increase real choices) * Encourage Minnesotans to take responsibility for their own health care decisions. Most of our most expensive and widespread health problems are due to our own personal lifestyle decisions. Response from Ken Pentel I will establish a single payer healthcare system that is universal. This would eliminate the multi-payers, advertising and marketing. A state hospital board would be established to distribute technologies and expertise fairly in MN. And we will set fees on a menu for hospitals, doctors and drugs. The first and second year we would establish a single payer healthcare board that sets fee’s for drugs, doctors and hospitals. In the third year we would cover all the uninsured children. The forth and fifth year we would phase-in coverage for all. All Minnesotans would have a health card, go into the doctor or hospital, following their procedure, their card would be swiped. The bill would go to the State, the State would pay. Simple and easy. Overhead would go from 30% in the existing system to 2%. Single-payer would take the weight of health coverage off the shoulders of employers, schools and farmers and others. We would pay for the system from the saving in overhead and administrative costs, as well as a progressive income tax and pollution tax. Every other democracy in the world has healthcare for all. It’s unacceptable that we tolerate the existing condition. Universal Single-Payer is way overdue. Response from Leslie Davis - A Everyone in Minnesota should get decent cost effective medical or health care. There is no one size fits all to health care and I offer two arrows for the quiver of solutions and three benefits that could arise. One is to reduce the cost of medical care and two is to expand the range of solutions to medical treatment to areas such as homeopathy, massage, acupuncture and the entire range of alternative medicines and medical procedures. However, the age old saying that an ounce of prevention is worth a pound of cure is even more valid today in the era of skyrocketing costs. Prevention and education on personal responsibility is the first line of medical and health care defense. Allow qualified nurses, physician assistants, paramedics and others to staff offices and perform many medical procedures now relegated to doctors only. Most medical tasks do not require expensive doctor attention. This would reduce medical costs because routine tasks would be billed out at the much cheaper rate, doctor salaries would fall since they wouldn’t have to handle the same case load and competition would increase, which always leads to lower prices and better quality. By having new medical training levels and specialties many more students would be drawn to medicine without having to devote the time and money to becoming a full fledged physician. There are millions of potential students out there who have the intelligence to do the work but can’t go all the way through medical school because of financial, work, or family obligations. Or maybe they’re part of the more than ninety percent of applicants that are denied entrance to medical school because of the requirements or the number of admissions. We should allow certain tasks to be handled by these lesser-trained, but qualified, individuals. If people are concerned that more mistakes may be made they have the choice of seeking a full fledged licensed physician. If they want to save some money they might choose a nurse practitioner or other alternative. In reality, choosing a nurse might even get them better attention and better medical care than a busy doctor. Besides, many doctors regularly refer many of their patients to their specialist friends anyway. If a complex problem were to arise a person could always seek a fully-licensed physician. In other words, take the mystery out of medicine and drugs and allow the expansion of care providers and care alternatives. Response from Walt Brown - Q Minnesotans enjoy some the best health care of any state in the union. For that we should all be grateful. Healthcare can be more accessible and more affordable for many Minnesotans by more fairly and accurately determining the costs of premiums according to ability as well as need. Every decision I make will be sincerely based on the premise that taxes will not be raised. By standing on my promise to Quit Raising Taxes, you can be sure that my administration will find solutions and not rely on buying excuses with your tax dollars. Three goals I have that I wish to share with you include (1) Taxes of any kind shall not be raised to further health care needs, (2) State assistance to the needy will not be forsaken as reasonable premiums will be properly established, and (3) The private and charitable sectors of our state will be encouraged by my administration to continue generous programs and to increase efforts. Thank you. Response from Tim Pawlenty - R Minnesota continues to have the healthiest people in the nation and the lowest rate of uninsured. However, America’s health care delivery system is broken. Rising health care costs are pinching families, businesses and government, and relief is urgently needed. We have begun nation-leading health care reform during my term. This last year, health care premium increases slowed to their lowest rate of growth in decades. Still more needs to be done. Mike Hatch wants a government-run system. I believe we should put patients and doctors in charge. Our nation-leading efforts forcing price disclosure and quality measurements, paying for better care rather than just the volume of procedures, reducing administrative overhead and bureaucracy, expanding electronic medical records, taking on the prescription drug companies and holding down costs, have all had a positive impact. My first goal in this area will be to expand those efforts during my second term with additional transparency in the health care system. We’ve made good progress with efforts such as our nation-leading RxPrice Compare website which allows Minnesotans to comparison shop for prescriptions by city or zip code. Since the program started, prices have dropped on 77% of generics and 54% on brand name drugs. By using the market and price transparency we are seeing results. An example of cost transparency is in the field of lasik eye surgery. Here the cost has dropped because consumers can discover the cost of the procedure and “shop” based on cost and quality. This doesn’t work for all aspects of health care, but it provides insight into how we can improve a portion of the system. My second goal is to continue to maintain Minnesota’s ranking as the state with the lowest number of uninsured and to work to reduce that number. A third goal will be to transform and realign health care payments to reward results and outcomes and maximize the proportion of spending that goes to effective care. Our QCare (Quality Care And Rewarding Excellence) system, implemented by executive order this year, helps empower consumers and rewards providers for results. This means establishing high standards for outcomes in areas such as diabetic and cardiovascular care, which together are estimated to save $153 million a year. Our efforts are being noticed. Just this summer, the federal government established efforts to control health care costs which are modeled after Minnesota’s plan. category:Planks_from_elsewhere category:wellness